Tziakas, D; Chalikias, G; Al-Lamee, R; Kaski, JC
(2021)
Total coronary occlusion in non ST elevation myocardial infarction: Time to change our practice?
Int J Cardiol, 329.
pp. 1-8.
ISSN 1874-1754
https://doi.org/10.1016/j.ijcard.2020.12.082
SGUL Authors: Kaski, Juan Carlos
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Abstract
Based on 12‑lead electrocardiogram (ECG) findings, myocardial infarction (MI) patients are dichotomized to ST-elevation MI (STEMI) and non ST-elevation MI (NSTEMI) in terms of management strategy. NSTEMI patients are increasing in numbers worldwide, among which an approximately 30% are associated with a total occlusion of a coronary artery. This review summarizes recent evidence in epidemiology, clinical, laboratory, ECG and prognostic characteristics of this NSTEMI sub-group. Patients with a diagnosis of NSTEMI and a total occluded coronary artery (TOCA) represent a sub-group of NSTEMI patients with total occlusion of coronary arteries and associated high-risk that are frequently not managed according to a STEMI-like pathway. The present review echoes a call for action in changing our everyday clinical practice. Therefore, we propose a new triage algorithm by which recognition of high-risk features in NSTEMI patients is central in order to identify STEMI 'equivalents' among NSTEMI patients in terms of similar pathology and high-risk who may benefit from immediate invasive strategy (<2 h).
Item Type: | Article | ||||||||
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Additional Information: | © 2021. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/ | ||||||||
Keywords: | Immediate invasive strategy, Non-ST elevation myocardial infarction, ST elevation myocardial infarction equivalent, Total occlusion, Immediate invasive strategy, Non-ST elevation myocardial infarction, ST elevation myocardial infarction equivalent, Total occlusion, Cardiovascular System & Hematology, 1102 Cardiorespiratory Medicine and Haematology | ||||||||
SGUL Research Institute / Research Centre: | Academic Structure > Molecular and Clinical Sciences Research Institute (MCS) | ||||||||
Journal or Publication Title: | Int J Cardiol | ||||||||
ISSN: | 1874-1754 | ||||||||
Language: | eng | ||||||||
Dates: |
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Publisher License: | Creative Commons: Attribution-Noncommercial-No Derivative Works 4.0 | ||||||||
PubMed ID: | 33412179 | ||||||||
Go to PubMed abstract | |||||||||
URI: | https://openaccess.sgul.ac.uk/id/eprint/112857 | ||||||||
Publisher's version: | https://doi.org/10.1016/j.ijcard.2020.12.082 |
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